Orthopaedic surgeon Adam Levin knows that close collaboration is the key to good outcomes for cancer patients. “Our multidisciplinary approach to difficult soft tissue and bone sarcomas is better than any I have ever seen,” he says.
As he prepares for the weekly tumor board meeting, where the case of nearly every sarcoma patient at Johns Hopkins is reviewed, Levin describes the meetings value. “This forum lets us bring everyone into the room for a true multidisciplinary discussion about the patients, their treatment and their follow-up,” he says.
Attendees include specialists from orthopaedic surgery, adult and pediatric medical oncology, general surgical oncology, radiation oncology and neurosurgery. Additional surgical subspecialists, such as plastic surgery, urology, vascular surgery and gynecology, are consulted as needed.
But the collaborative approach to patient care does not stop there.
Every other week, the team holds a multidisciplinary sarcoma clinic organized by Carol Morris, former chief of orthopaedic oncology. Patients send their medical images in advance and come for a “one-stop” consultation with all of the appropriate services. Rather than having to coordinate visits with multiple specialists, patients save time and energy with just a single appointment. This is particularly helpful for patients traveling from outside the state.
“We work closely with our sarcoma-dedicated specialists in pathology and radiology,” says Levin. “They integrate into our preoperative and postoperative conferences and our day-to-day discussions of the pathology findings. With this approach, we are able to do smaller biopsies very quickly with a high success rate and great degree of accuracy.”
This integration also allows precise coordination of interdigitated chemotherapy and radiation therapy. Before surgery, radiation oncologists and medical oncologists plan alternating sessions to treat high-grade soft tissue sarcomas to produce the maximum benefit.
In addition to its clinical collaboration, the sarcoma team coordinates its research efforts. Patients in the sarcoma clinic have donated blood and tissue to a tissue banking protocol. “Because of patient contributions to our research, we can look at sarcoma pathways down the line and investigate novel therapeutics,” says Levin.
The sarcoma team meets every two weeks to review clinical and translational research projects and interests. This optimizes coordination, stimulates new ideas and develops broader perspectives on patient care.
In an ongoing effort to improve coordination and access to care, the Department of Orthopaedic Surgery has added two surgeons to the sarcoma team. Richard Schaefer has had a distinguished military career and brings a wealth of clinical and educational experience, and Jonathan Forsberg will help integrate the care of patients between The Johns Hopkins Hospital in Baltimore and Sibley Memorial Hospital in Washington, D.C. They will both support the collaborative efforts of the sarcoma team.
Teamwork continues to be the mantra. “We’re bringing together researchers and clinicians from different backgrounds to solve problems,” says Levin. “This collaborative approach is why I’m here.”
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